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Alex Fulton
Alex Fulton has been working in the wellness field for more than 20 years. She has written extensively about integrative medicine, herbalism, supplements and other topics related to holistic health. Alex also focuses on issues related to women's health, from menstruation to menopause. She has collaborated with physicians, midwives and functional medicine practitioners to promote natural approaches to health care for women. She has a BA in English from the University of Wisconsin-Madison.
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Clinically Speaking: Questions to Ask Your Healthcare Provider About Head and Neck Cancer
If you've received a head and neck cancer diagnosis, here are some important questions to ask your healthcare provider.
If you've recently received a diagnosis of head and neck cancer, you may be feeling overwhelmed and unsure about what to do next. HealthyWomen asked Eleni Rettig, M.D., a head and neck surgeon at Brigham and Women's Hospital and Dana-Farber Cancer Institute at Harvard Medical School, to suggest questions you should ask your healthcare provider about head and neck cancer.
What type of head and neck cancer do I have?
Why this question is important:
There are a number of types of head and neck cancer, including those in the throat, voice box, mouth and lips. It's important to understand which type of cancer you have because each one has unique considerations for treatment and prognosis and may be managed by different teams of specialists.
Is this cancer hereditary?
Why this question is important:
While some head and neck cancers may have a genetic component, very few of them are hereditary. It's important to know whether your cancer is hereditary so you can determine whether your family members may also be at risk and whether you should get additional testing.
Was my cancer caused by HPV?
Why this questions is important:
Rettig said people with cancer of the oropharynx, which includes the tonsils and back of the tongue, need to know whether their cancer is caused by the human papillomavirus, or HPV. "HPV-positive oropharynx cancers have a better prognosis than HPV-negative cancers," Rettig said.
Will my treatment be specific to my HPV status?
Why this question is important:
Right now the treatment for oropharynx cancer is the same regardless of HPV tumor status, but there are many clinical trials underway to determine whether HPV-positive oropharynx can be safely managed with less treatment than what is given for HPV-negative cancers.
What are my treatment options?
Why this question is important:
Treatment options — which include surgery, radiation and chemotherapy — are different for each person and are based on factors such as their individual health, what type of tumor they have and what stage the cancer is in.
New ways of treating head and neck cancer are also being studied; these include precision medicine, where a treatment is specifically designed for a person's cancer, and immunotherapy, which activates the immune system to target cancer cells.
What are the side effects of treatment?
Why this question is important:
Side effects of head and neck cancer are very different for each patient, so it's important to ask your doctors what to expect in your particular situation.
"Depending on which treatment you have, side effects and their effect on your quality of life can range from minimal to severe. If you have extensive surgery and/or radiation, you may experience changes in your speech, swallowing and even appearance," Rettig said.
What is the survival rate of this cancer?
Why this question is important:
Factors that affect survival of head and neck cancer include the type of cancer, stage of the disease and, for oropharynx cancers, the HPV status of the tumor.
"Asking about average survival rates can give you a general sense for your prognosis, but it is also important to remember that each patient's experience is unique," Rettig said.
If I haven’t been vaccinated already, should I still consider the HPV vaccine after diagnosis or treatment?
Why this question is important:
The HPV vaccine available in the United States protects against nine types of HPV infection. If you've already been treated for HPV-positive cancer, getting the vaccine will not have an effect on the course of that particular cancer. However, it could protect you against a new infection from other types of HPV that you haven't been exposed to yet.
What specialists do I need to contact?
Why this question is important:
Rettig suggested asking your doctor to recommend a head and neck oncology practice, which typically includes a surgeon, radiation oncologist and medical oncologist. Finding the right specialists is important because they have specialized knowledge and are better equipped to meet your specific treatment needs.
What support services and resources are available to me and my loved ones?
Why this question is important:
Since caring for a loved one with cancer can be emotionally and physically draining, friends and family who will be helping you through your treatment may want to seek out a support group for caregivers.
Rettig pointed to Support for People with Oral and Head and Neck Cancer, a national support organization, and the American Head & Neck Society as great sources of support and information.
This resource was created with support from Merck.
- Fast Facts: What You Need to Know About Head and Neck Cancer ›
- Understanding Head and Neck Cancer ›
- Coping With the Emotional Impact of Head and Neck Cancer - HealthyWomen ›
- Ask the Expert: Head and Neck Cancer - HealthyWomen ›
- Reduce the Risk of Head and Neck Cancers - HealthyWomen ›
- Symptoms of Head and Neck Cancer - HealthyWomen ›
- Locations of Head and Neck Cancer - HealthyWomen ›
- True or False: Head and Neck Cancers ›
- Verdadero o falso: Cánceres de cabeza y cuello - HealthyWomen ›
- Managing Side Effects of Head and Neck Cancer Treatments - HealthyWomen ›
- Ubicaciones del cáncer de cabeza y cuello - HealthyWomen ›
- Síntomas de cáncer de cabeza y cuello - HealthyWomen ›
“Cardiovascular disease” is a term for the group of diseases that affect your heart and blood vessels, including stroke, coronary heart disease, heart failure, heart valve disease, atherosclerosis (hardened arteries), hypertension or a heart arrhythmia. If your clinician thinks you may have a cardiovascular disease, expect further testing.
Fortunately, many types of cardiac diagnostic tests are available. Your clinician will order tests based on your specific medical situation. Tests include:
Blood tests
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- What it is: A needle inserted by a clinician into your vein to remove a small amount of blood.
- What it measures: Cholesterol, proteins like lipoprotein (a) or troponin, and inflammation markers like C-reactive protein. Your clinician will order specific tests based on your possible diagnosis.
- Used to: Assess your risk of cardiovascular disease, along with a physical exam and your medical history. Specific tests like troponin levels can confirm whether damage to your heart muscle has already occurred.
Blood pressure monitoring
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- What it is: An arm cuff that measures your blood pressure at clinic visits. You may also need to take your blood pressure at home.
- What it measures: How much pressure your blood puts on your arteries when your heart pumps.
- Used to: Provide an early warning system of heart disease, even when there are no symptoms, since high blood pressure can damage your heart muscle and blood vessels over time.
- Other uses: During a medical emergency, blood pressure monitoring can alert the team to sudden status changes.
According to the American Heart Association, blood pressure categories are:
Normal: Less than 120 mm Hg systolic (top number) and 80 mm Hg diastolic (bottom number)
Elevated: 120–129 mm Hg systolic and less than 80 mm Hg diastolic
Stage 1 hypertension: 130–139 mm Hg systolic or 80–89 mm Hg diastolic
Stage 2 hypertension: 140 mm Hg or higher systolic or 90 mm Hg or higher diastolic
Severe hypertension: 180 mm Hg or higher systolic or 120 mm Hg or higher diastolic
Chest X-ray
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- What it is: An X-ray that shows the heart, lungs and ribcage. It can’t show the structures inside the heart.
- What it measures: A chest X-ray shows the size, shape, and location of the heart and lungs. Some nearby blood vessels will also appear in the image.
- Used to: Help diagnose the cause of symptoms like chest pain, fever, breathing difficulties or a stubborn cough.
Echocardiogram (heart ultrasound)
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- What it is: A test that uses sound waves to create pictures of the heart. The most common kind is called a transthoracic echocardiogram (TTE), where the clinician waves the ultrasound wand over your chest. There is also a transesophageal echocardiogram (TEE), where your clinician places the ultrasound wand down your throat to get a clear view of your heart or aorta.
- What it measures: Your heart’s structure and how well it works, including its pumping strength and valve health.
- Used to: Help diagnose heart muscle damage, heart valve disease or heart failure.
Electrocardiogram (ECG or EKG)
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- What it is: Electrodes applied to your body that are connected to an EKG machine.
- What it measures: Electrical waves in the heart and how fast and regularly your heart beats. Each time your heart beats, it creates an electrical wave. This wave makes the heart muscle squeeze, which pumps blood from the heart.
- Used to: Diagnose and monitor many heart conditions, including heart attack, heart failure, heart valve disease, coronary artery disease and heart arrhythmias (irregular heartbeats).
- Other uses: Can help diagnose a pulmonary embolism, inflammation of the heart’s sac, or abnormal blood levels of potassium or calcium.
Tilt table test
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- What it is: A test where you lie on a special motorized table that goes from flat to an angle that mimics sitting up. A technician will monitor your vital signs and symptoms like slow heart rate, low blood pressure, fainting, lightheadedness or nausea.
- What it measures: Whether blood pooling in your veins causes these symptoms.
- Used to: Help diagnose postural orthostatic tachycardia syndrome (POTS), vasovagal syncope and similar conditions.
Exercise cardiac stress test
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- What it is: A test that requires walking on a treadmill or riding an exercise bike in a medical setting while hooked up to monitoring equipment. Your clinician will also check your blood pressure after the test.
- What it measures: How well your heart pumps blood.
- Used to: Diagnose coronary heart disease or find the cause of symptoms like chest pain or shortness of breath.
- Other uses: Can also help predict the risk of a heart attack or eligibility for surgery or a safe level of exercise.
Holter monitoring
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- What it is: A small wearable device that records your heart’s rhythm over 24 to 48 hours. Your clinician might order Holter monitoring if you have had fainting spells or dizziness, or an EKG did not provide enough information.
- What it measures: Your heart’s rhythm throughout the testing period.
- Used to: Detect irregular heartbeat (arrhythmia).
Cardiac CT scan
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- What it is: X-rays taken from many angles used to create a detailed 3D image of your heart and nearby blood vessels. Some high-resolution scanners can even show your heart in motion.
- What it measures: The anatomy and function of your heart, valves, blood vessels and related structures.
- Used to: Diagnose or monitor chest pain, blockages in your arteries, and problems with your aorta or heart valves.
- Other uses: Often used to help plan cardiac procedures, including minimally invasive or robotic heart surgeries.
Cardiac MRI scan
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- What it is: A magnetic field plus radiofrequency waves used to create detailed 3D pictures of blood vessels and the inside of the heart, including valves.
- What it measures: How well the heart and valves are functioning and whether enough blood is flowing through your major blood vessels.
- Used to: Diagnose or monitor advanced or complicated heart conditions after other testing has been done.
Cardiac catheterization
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- What it is: A small tube, or catheter, that gets inserted into one of your large veins to thread it up to your heart. Once there, the clinician will check your heart’s blood flow or the inside of your blood vessels for problems.
- What it measures: How well your heart works and how healthy your valves and blood vessels are.
- Used to: Diagnose blocked or narrowed arteries or valves.
- Other uses: Unlike other diagnostic tests, cardiac catheterization allows your clinician to move from diagnosis to a corrective procedure immediately if needed. Possible procedures include clearing a blocked artery or partially blocked heart valve or taking tissue samples from the heart to study under a microscope.
Coronary angiogram
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- What it is: A specific type of cardiac catheterization. Once your clinician threads the catheter to your heart, they will take X-rays using contrast dye to check the large arteries near your heart for blockages.
- What it measures: How healthy the arteries near your heart are.
- Used to: Diagnose and then correct blocked arteries near your heart.
This educational resource was created with support from Merck.
Alex Fulton has been working in the wellness field for more than 20 years. She has written extensively about integrative medicine, herbalism, supplements and other topics related to holistic health. Alex also focuses on issues related to women's health, from menstruation to menopause. She has collaborated with physicians, midwives and functional medicine practitioners to promote natural approaches to health care for women. She has a BA in English from the University of Wisconsin-Madison.
Medically reviewed by Jennifer Grandis, M.D.










